Abstract：Objective：To observe the clinical effect of Jianpi Yiwei Tongluo Prescription combined with quadruple therapy on chronic atrophic gastritis (CAG) of spleen-stomach weakness type with helicobacter pylori (Hp) positive patients. Methods：A total of 104 CAG with Hp positive patients were randomly divided into the combination group and the western medicine group， with 52 cases in each group. The western medicine group was given quadruple therapy，and the combination group was given Jianpi Yiwei Tongluo Decoction combined with quadruple therapy. After eight weeks of continuous treatment， the clinical effects， traditional Chinese medicine (TCM) syndrome scores， scores of histopathological indexes， Chinese version of the MOS item short-from health survey (SF-36) and serum pepsinogen levels were compared between the two groups. Results：After treatment，the total effective rate was 94.23% in the combination group and 80.77% in the western medicine group，the difference being significant (P＜0.05). After treatment， the TCM syndrome scores of stomach cavity distention and fullness or dull pain， relief with warmth and pressing， stomach cavity oppression after meals， poor appetite and digestion， fatigue and lack of strength，and shortness of breath and laziness to talk in the two groups were decreased when compared with those before treatment (P＜0.05)， and the above scores in the combination group were lower than those in the western medicine group (P＜0.05). After treatment， the scores of dysplasia， intestinal metaplasia， atrophy， chronic inflammation， activity and Hp infection in the two groups were decreased when compared with those before treatment (P＜0.05)， and the above scores of histopathological indexes in the combination group were lower than those in the western medicine group (P＜0.05). Before treatment， there was no significant difference in the comparison of SF-36 score between the two groups (P＞0.05)； after treatment， the SF-36 scores in the two groups were significantly increased when compared with those before treatment (P＜0.05)，and the SF-36 score in the combination group was higher than that in the western medicine group (P＜0.05). After treatment， the levels of pepsinogenⅠin the two groups were increased when compared with those before treatment (P＜ 0.05)，and the level of pepsinogenⅠin the combination group was higher than that in the western medicine group (P＜0.05)；the levels of pepsinogenⅡin the two groups were decreased when compared with those before treatment (P＜0.05)，and the level of pepsinogenⅡin the combination group was lower than that in the western medicine group (P＜0.05). Conclusion： Jianpi Yiwei Tongluo Prescription combined with quadruple therapy has a great therapeutic effect on the treatment of CAG of spleen-stomach weakness type with Hp positive patients，which can accelerate the recovery of clinical symptoms and gastric mucosal pathological tissue，regulate the secretion of pepsinogen，and improve the quality of life.